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Dementia

Introduction

If you, or someone you know, have been given a dementia diagnosis, we expect you’ll have lots of important questions – especially if this is your first experience of the condition.

This is likely to be a worrying time for you and your family, and you may be feeling a mixture of emotions. This is perfectly normal. There are millions of people all over the world with a dementia diagnosis and every person will experience it differently, but you are not alone and there is a lot of dementia support available to you.

We are here to try and help explain what dementia symptoms are, what causes dementia, what dementia treatments are available and about living with dementia in general.

We will refer you to a number of other sources that can offer help and support, but if you have any queries or concerns about your condition, or if you think you are experiencing any dementia symptoms detailed here, please see your GP.

What is dementia?

Dementia is an umbrella term that describes a large range of progressive neurological conditions and their symptoms. Dementia affects how your brain works, especially the functions of memory, thinking and reason. There are many different types of dementia and some people are diagnosed with more than one type. Alzheimer’s disease is the most common type of dementia but there are several others. See our ‘Main types of dementia’ section for more information.

The risk of having dementia increases as we get older. Dementia usually affects people over the age of 65 but certain dementia types can occur earlier. This is referred to as ‘early onset’ dementia. We don’t yet know why some people experience dementia and other people age with no decline in their cognitive abilities. Scientists believe genetic, lifestyle and environmental factors all play a role.

For further explanations as to what dementia is, please visit the NHS website.

What causes dementia?

The main cause of dementia is damage to brain cells. The type of dementia you are diagnosed with will determine exactly how this damage is occurring. For example, Alzheimer’s disease develops due to a build-up of abnormal proteins in the brain cells which damage their internal structure.

The type of dementia symptoms you experience depends on the area or areas of the brain that are affected:

Did you know... "Dementia is an umbrella term for a range of conditions that have similar symptoms."

Main Types of Dementia

Here we explain the types of dementia and what causes dementia of each type.

As we outlined earlier, dementia is not one condition but an umbrella term for a number of different diseases. Each condition presents itself with a different set of symptoms, and may have a different cause. There are five main diseases that cause dementia, which we discuss in further detail below.

• Alzheimer’s disease – this type of dementia causes abnormal proteins to build up in brain cells and damage their internal structure. This reduces the efficiency of the connections between brain cells and cells begin to die. The first symptoms noticed are usually memory, language and problem solving difficulties. Visit the Alzheimer’s Society website for more information about this type of dementia

• Vascular dementia – the second most common type of dementia, caused by reduced blood flow and oxygen supply to the brain. This often occurs due to a series of small strokes or one large stroke. Vascular dementia symptoms are similar to symptoms of Alzheimer’s disease, and mainly involve issues with feeling confused, problem-solving, planning, thinking quickly and concentrating. For more information on this type of dementia, read the Alzheimer Scotland factsheet

• Mixed dementia – this is a combination of dementia types. For example, it is common to experience dementia symptoms consistent with Alzheimer’s disease and vascular dementia, or Alzheimer’s disease and dementia with Lewy bodies or Parkinson’s disease

• Dementia with Lewy bodies – this type of dementia causes tiny structures (Lewy bodies) to form abnormally inside brain cells, which disrupts the chemistry of the brain and causes cells to die. Symptoms include problems with understanding and thinking, slow movement (stiff limbs and tremors), balance problems and hallucinations. For more information on dementia with Lewy bodies, visit The Lewy Body Society website

• Frontotemporal dementia (including Pick’s disease) – this is a fairly uncommon form of dementia that affects the frontal and temporal lobes. This type of dementia causes clumps of abnormal proteins to form inside brain cells. Depending on which areas of the brain are damaged, the person may experience personality changes, language problems, become easily distracted, find it difficult to plan or organise

For more information on the types of dementia, see the Dementia Care website.

Did you know... "Around 800,000 people in the UK are living with dementia."

Dementia Symptoms

Dementia symptoms usually come on gradually and get worse over time, often over a number of years.

Some symptoms start off so mildly that it takes the person and their family a while to realise there may be a problem. A person’s daily life will be affected by dementia, although there are dementia treatments available to help manage some of them. Some symptoms listed below may occur as a result of the normal ageing process or as a result of other conditions or taking certain medications. If you are concerned that you may have any of the symptoms discussed below, please see your GP.

Early symptoms of dementia may include any or all of the following:

• Memory problems: short term memory is usually affected first, and people often retain memories of their pasts for a much longer time

• Finding it hard to follow conversations, TV stories or understand what you are reading

• Having trouble remembering the day or date, names of people or things, where you put something

Everyone experiences dementia symptoms differently and many people live fairly independently for several years whilst in the earlier stages of their dementia. As their condition progresses though, symptoms may become much less manageable and eventually quite severe. Often, the person is likely to need full time care and support.

Dementia symptoms in the later stages may additionally include:

• Significant memory loss, e.g. being unable to remember even close relatives

• Communication problems, e.g. may eventually lose the ability to speak

• Mobility decline, e.g. may become unable to walk

• Unusual behaviour, e.g. wandering, rocking or agitation

• Difficulties eating due to muscle loss

• Incontinence

• Increased risk of infections

Products

At NRS Healthcare, we offer a huge range of equipment that can help those who are older, or have a health condition, live more independently. Below you’ll find some of our most popular products which can help relieve some of the symptoms of dementia and enable those living with the condition to do more things for themselves – whether at home or when out and about.

Receiving a dementia diagnosis

If you're worried that someone you know is showing symptoms of dementia, it can be quite difficult to raise this with the person. They may not be fully aware that they are showing any of these signs, or they may have noticed too and be fearful of seeking help or advice. Try to broach the subject gently and ask if they have noticed that they are behaving differently. Encourage them to make an appointment and offer to go along with them.

If you are worried about your own memory or any of the dementia symptoms you have read about above, it's a good idea to see your GP. Some of these may be symptoms of other healthcare conditions or even side effects from taking certain medications, and your GP will be able to take some blood tests and give you some mental exercises to find out how likely it is that you have dementia. If they are concerned, you will be referred to a neurologist, an elderly care physician, or a psychiatrist with experience of making a dementia diagnosis.

Did you know... "Many people continue to live independently in the early stages of dementia."

Living with Dementia

Here we discuss several aspects of living with dementia, including dementia treatment, dementia products that may help you, exercise for dementia, diet for dementia and proven sources of help.

Living with dementia is a different experience for everyone. Many people continue to live relatively independently for a number of years but may require support from family and friends. Daily living tasks may become increasingly difficult as time goes on and you may need additional help and support.

Impact on daily living

If you are finding day to day activities, such as getting dressed, using the bathroom or preparing food, more difficult due to your dementia, speak to your GP or your local social care provider. They may be able to arrange for you to have an assessment from an Occupational Therapist (OT) who can visit you to find out what you need help with, look at ways you can do things differently and recommend equipment that may help you in the home.

At NRS Healthcare, we are experts in providing equipment that helps support people to live independently or with the help of a carer, including dementia products. We have a team of OTs who can offer advice on what aids for dementia may help you. Here is a selection of dementia aids that can help make life a little easier:

Products for memory loss:

Simple devices such as a Memo Minder can help you by playing automatic reminder messages when you walk by, for example, if you are likely to forget to lock your door as you leave the house.

Products for keeping in touch with people:

If you have dementia and live alone or spend a lot of time in your own company, it may be useful for you to have an easy way to contact friends, family members or neighbours, especially if there is an emergency. A simple mobile phone with just a few pre-programmable phone numbers and an SOS button would be ideal.

Mobility problems:

Some people find they begin to walk a little unsteadily or shuffle around. Grab rails positioned around the home and walking frames can help you keep your balance and avoid falls.

We also offer a host of other dementia aids, depending on the dementia symptoms you are experiencing, as well as a large range of equipment to help if you are caring for someone with dementia. Contact our occupational therapy product advice team for advice on what dementia products could assist you.

Dementia treatments

Most types of dementia cannot be cured, although research is continuing into developing drugs, vaccines and other medical treatments for dementia.

There are drug treatments for dementia that aim to reduce the severity of symptoms and which may help to slow down the progression of the disease.

If you have a diagnosis of Alzheimer’s disease or mixed dementia, there are a number of treatments that your specialist may recommend to you, including prescribed drugs such as donepezil, rivastigmine or galantamine. In later stages of Alzheimer’s disease, memantine is often prescribed.

There are a number of other non-drug based treatments that may be recommended to you. These can help you manage the symptoms of dementia and improve your quality of life. Taking part in meaningful activities is enjoyable and leads to increased confidence and self-esteem. You may be encouraged to undertake:

• Talking therapies: such as counselling, which can help someone come to terms with their diagnosis or discuss their feelings

• Cognitive behavioural therapy (CBT): helps manage depression and anxiety which some people will experience

• Life story work: encourages you to share life experiences to help with communication and memory. Read more about life story work on the Dementia UK site

Dementia diet

Evidence suggests that eating a Mediterranean-style diet can reduce the risk of developing dementia. There is currently little evidence to suggest that a special diet can delay the development of dementia in people already diagnosed, but it is advisable to eat a healthy diet which will improve your general health and boost immunity.

As dementia progresses, eating and drinking may become more of a challenge. A person with dementia may change their attitude towards food, for example they may begin disliking foods they used to enjoy.

Similarly, depression, oral pain or discomfort, medication, tiredness and using less energy can all decrease the person’s appetite.

Exercise for dementia

Alzheimer’s Society provides a factsheet about eating and drinking with dementia including tips for carers.

Some people take dementia supplements such as vitamins and minerals because they believe these help to reduce some of their symptoms and may have positive effects such as slowing down the progression of the condition. Omega-3 (found in oily fish), B vitamins and folic acid are often taken. There is little clinical evidence to support the use of dementia supplements. Living a healthy lifestyle is the most important factor to help reduce the risk of dementia developing.

Exercise is considered one of the best ways to reduce the risk of developing dementia. Exercise for dementia patients may bring the following benefits:

• Improve heart health and decrease the risk of heart disease

• Reduce the risk of some types of cancer

• Reduce the risk of stroke and type 2 diabetes

• Retain mobility, strength, balance and flexibility for longer

• Keep bones strong

• Improve memory

• Increase self-esteem and mood

People in the early or middle-stages of dementia are usually able to find an exercise that suits their abilities or continue doing those that they have always enjoyed. Local community or sports centres often provide a range of organised exercise and physical activity sessions, such as ball games, seated exercises, tai chi, music and dance, indoor bowls or swimming.

Increasing the amount of physical activity carried out during the day all counts as exercise too, for example, walking, gardening and housework.

Dementia and employment

If you receive a dementia diagnosis, it does not necessarily mean you are unable to work anymore. Many people continue to work for a long time after they are diagnosed. If you are able to carry on working, it may help your wellbeing, mood and cognitive abilities.

You should inform your employer that you have been diagnosed with dementia and of your intention to continue with or leave employment. They have a legal duty not to discriminate and to make reasonable adjustments to ensure you are not disadvantaged in the workplace.

A disability employment adviser (DEA) at a Jobcentre Plus office can advise on speaking to your employer.

Don’t rush into a decision – take time to consider the options and find the right solution for you.

Did you know... "There are a number of medicines and non-drug treatments to manage the symptoms of dementia."

Support for Dementia

Remember - you are not alone!

A dementia diagnosis can come as a shock to the person with the condition and those around them. However, there are sources of help and support for everyone involved. It's natural to worry about the future, but it's important to remember that you're not alone. If you are caring for someone with dementia, it is important to recognise that you have needs as well. Caring for someone with a long-term condition can take its toll on your personal life, health and wellbeing, so try to eat right, exercise, take breaks as often as you can, and use the dementia help and support systems available to you.

Rare Dementia Support – runs specialist support services for individuals living with, or affected by, one of five rare dementia diagnoses

Young Dementia UK – charity that helps people whose lives are affected by young onset dementia

Did you know... "Online communities are great for carers, and those living with dementia, to share their experiences."

Glossary

Unsure what something means? Checkout our Glossary section below.

Although we always try to explain things as simply and as clearly as possible, sometimes it’s necessary to use the correct medical terminology. Medical terms are often known for being tricky to pronounce and if you’re not an expert in the subject, they can also be a little difficult to understand. Below, we’ve put together a list of terms used on this page along with a brief explanation of what they mean to help make your understanding of dementia as straightforward as possible.

Abnormal proteins

– these are normally found throughout the body but for reasons we do not yet know, some proteins such as amyloid can build up between nerve cells, which form abnormal clusters or ‘plaques’ that cause death of the cells

Cerebrum

– largest part of the human brain, positioned at the top of the skull, divided into a right and left hemisphere. Right half of the cerebrum controls the left side of the body, and vice versa. Divided into four regions called ‘lobes’

Cerebellum

– part of the brain located at the back of the skull which coordinates muscular activity

Donepezil

– a drug used to treat confusion, improve memory, awareness, and the ability to function by restoring the balance of natural substances (neurotransmitters) in the brain

Early onset dementia

– also known as ‘young onset dementia’, referring to dementia that develops in people aged between 40 and 60

Frontal lobe

– part of the brain lying immediately behind the forehead that helps solve complex tasks

Galantamine

– a drug used for the treatment of mild to moderate Alzheimer's disease and various other memory impairments, in particular those of vascular origin

Hippocampus

– a small region of the brain located immediately beneath the cerebrum and is associated with memory and spatial navigation

– a drug used to treat moderate to severe Alzheimer-type dementia. It works by blocking excess activity of a substance in the brain called glutamate, which may reduce the symptoms associated with Alzheimer disease

Occipital lobe

– part of the brain found in the back of the cerebrum that processes visual information

Parietal lobe

– part of the brain found between the frontal and occipital lobes. Communicates sensations to the brain and helps avoid potentially harmful situations

Pick’s disease

– another term to describe Frontotemporal dementia, where the frontal and temporal lobes of the brain shrink

Rivastigmine

– a drug used to help improve the function of nerve cells in the brain

Temporal lobe

– the brain has two of these, one in each hemisphere. Processes information from the ears